Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The frequency of Nocardia infection in HIV-infected patients has increased during the past few years from 0.3% in 1985 to 1.8% in 1989. Although it is not of great concern as an AIDS-associated infection, the nonspecific clinical presentation in these patients might be confused with other lung infections such as tuberculosis (TB). The mortality rate can be as high as 60%. The authors diagnosed three homosexual men with nocardiasis among 1060 HIV-infected patients (0.2%) in a tertiary care center in Mexico City from 1981 to 1997. The mean age was 32 years. The CD4 count was less than 260 cells/mm3 in all these individuals. The clinical presentations were subacute sinusitis, chronic localized abdominal abscess, and acute disseminated nocardiasis. The respective associated infections were none; TB and cytomegalovirus (CMV); and candidiasis, TB, CMV, Isospora belli, and disseminated Mycobacterium avium complex (MAC). Trimethoprim/sulfamethoxazole (TMP/SMX) was the treatment in all the cases; at the time of this writing, two patients were living and one had died during the acute episode. A literature search uncovered 130 cases of Nocardia infection in HIV patients since 1982. According to the published data and our results, nocardiasis should be suspected in those HIV-infected patients who (1) do not respond to appropriate antituberculous treatment; (2) are intravenous drug users; and (3) develop a characteristic pericardial infection. Finally, adequate surgical or percutaneous drainage of abscesses are extremely valuable for diagnosis and therapy.
AIDS Patient Care STDS 1998 Nov
PMID:Nocardiasis in patients with HIV infection. 1955 69

A 35-year old HIV-infected man who has been on AZT and TMP-SMX for five years with CD4 cell counts fluctuating between 150/mm3 and 200/mm3 for the last three years is presented in this case history. Because of elevated serum amylase, he was advised not to add ddI or ddC and decided to discontinue AZT, taking only TMP-SMX for the last six weeks. He begins not to feel well and complains of weight loss, night sweats and a "funny" feeling in his left ear and swelling of his face. Upon examination his face is asymmetric with a pronounced firm, nontender fullness at the angle of his left mandible and a suggestion for similar swelling on the right. He has large (2 to 3 cm), firm, nontender posterior cervical nodes bilaterally, as well as bilateral 4 cm axillary and inguinal nodes. Routine blood chemistries are normal with the exception of the elevated amylase, and a chest X-ray shows increased interstitial markings. It is possible that the patient is on the way to developing Diffuse Infiltrative Lymphocytosis Syndrome (DILS), characterized by the presence of abnormally high numbers of circulating CD8 T cells that infiltrate salivary glands, lungs, and other organs. An elevated serum amylase accompanied by a normal serum lipase also suggests hyperamylasemia of salivary gland origin. Follow-up indicated that the patients' lipase was normal and biopsy of parotid glands was negative for malignancy. It was determined that ddI would not be a retroviral of choice in patients with elevated amylase; a combination of AZT and ddC would be a more prudent choice.
AIDS Clin Care 1995 Jan
PMID:Hyperamylasemia and facial swelling in an HIV-infected man. 1136 64

The newly approved use of an Atovaquone (Mepron) suspension for treating mild to moderate Pneumocystis carinii (PCP) in patients unable to tolerate trimethoprim-sulfamethoxazole (TMP-SMX), has shown that it is twice as bioavailable compared with the previously licensed tablet formulation. However, Atovaquone use has produced more deaths than TMP-SMX, a problem that may in part be due to its lack of a broad antibacterial spectrum.
AIDS Clin Care 1995 Jul
PMID:Atovaquone (Mepron) suspension approved by FDA. Food and Drug Administration. 1136 54

Researchers have found that patients presumed to be intolerant to TMP-SMX (trimethoprimsulfamethoxazole) can be desensitized with oral TMP-SMX and subsequently receive the drug for long periods of time. TMP-SMX is the drug of choice for preventing PCP. A study showed that 86 percent of AIDS patients who had varying degrees of intolerance to the drug were successfully desensitized by a rapid method of oral TMP-SMX. Several brand names of the generic drug are available: Bactrim, Septra, and Cotrim.
 ...
PMID:TMP-SMX desensitization. 1136 74

Dr. Bernard Bihari, an AIDS specialist practicing in New York City, and other members of the Community Programs for Clinical Research on AIDS (CPCRA), have determined that some of the Public Health Services's recommendations for preventing opportunistic infections do not match the standards of care that the CPCRA developed nearly five years ago. The basic treatments provided by Bihari include using 1) TMP-SMZ and fluconazole to prevent, respectively, Pneumocystis carinii pneumonia (PCP) and cryptococcal meningitis in patients with CD4 counts below 200; 2) using high-dose acyclovir to prevent cytomegalovirus disease when the CD4 counts drop below 150; and 3) using clarithromycin and ethambutol to prevent Mycobacterium avium complex when CD4 counts drop below 100. This protocol has kept many patients from developing these opportunistic infections. Bihari notes that while the Centers for Disease Control and Prevention (CDC) recommendations are based on FDA-approved treatments and large clinical trials, private practitioners do not necessarily have to follow them.
AIDS Alert 1995 Sep
PMID:Physician's aggressive preventive therapy differs. 1136 74

A case history is presented of an HIV-infected female patient with a recurrence of Pneumocystis carinii pneumonia (PCP) and contraindications to use of most drugs for PCP, including pentamidine, trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, primaquine, and dapsone. Treatment alternatives discussed address risk-benefit analyses of using different drugs. The final treatment decision was to use escalating doses of TMP-SMX, since her previous adverse effects (fever and rash) are not an absolute contraindication to readministration of the drug. Results of this TMP-SMX were good with trivial side effects.
AIDS Clin Care 1995 Sep
PMID:A difficult case of PCP. 1136 80

A case of a 45-year-old HIV-infected male who developed a severe throat infection with serious complications is reported. Despite a low CD4 count, the patient suffered only one significant illness in ten years since his diagnosed HIV infection. Overly aggressive antibiotic therapy caused fungal and thrush infections, leading to dehydration and extreme weight loss. The patient was treated with rehydration therapy, antifungal agents, and TMP-SMX, after which other complications, including multiple infections and B-cell lymphoma, were diagnosed. He refused chemotherapy after one course of treatment and was sent home with hospice care.
AIDS Clin Care 1996 Jan
PMID:Severe sore throat in a patient with AIDS. 1136 58

A great deal of attention at the XI International Conference on AIDS was focused on new approaches to managing and preventing AIDS-related opportunistic infections (OIs). Aside from a similar prevalence of Pneumocystis carinii pneumonia (PCP) in developed countries, a different spectrum of OIs is seen in less developed areas, such as Latin America, where many endemic diseases are included among OIs. Candidiasis has been the most common fungal pathogen, but a broader spectrum of mycoses is being seen, with fluconazole and itraconazole being the mainstays for treating these infections. Ganciclovir and foscarnet are still used to treat cytomegalovirus retinitis, but introduction of cidofovir represents a significant advance in treating this disease. Mycobacterium avium complex (MAC) is the third most common OI in developed countries, and delays in diagnosis and starting treatment are common. Trimethoprim-sulfamethoxazole (TMP/SMX) remains the drug of choice for PCP prophylaxis. Liposomal doxorubicin with or without other chemotherapy agents has been approved for treating Kaposi's sarcoma. A three-drug regimen of amphotericin B, flucytosine, and itraconazole is effective for treatment of HIV-infected patients with cryptococcosis. Bacterial infections can be treated with appropriate antibiotics, but adding intravenous immune globulin may decrease the occurrence of infections and increase the time between new infections.
J Int Assoc Physicians AIDS Care 1996 Oct
PMID:Opportunistic infections: the growing challenge. 1136 8

Reports from the 1997 Fourth Conference on Retroviruses and Opportunistic Infections reveal encouraging responses to the latest antiretroviral regimens, including using protease inhibitors for treating opportunistic infections. Unfortunately, there appears to be less interest in the development and validation of newer agents and regimens for opportunistic infection treatment and prevention. Reports are presented addressing the following areas: the impact of opportunistic infections on survival in HIV-infected patients; the success of protease inhibitors and antiretroviral therapy on opportunistic infections; the relationship of viral load plus CD4+ levels and prophylactic therapy for opportunistic infections. A report indicating that patients with a history of previous febrile reactions to trimethoprim/sulfamethoxazole (TMP/SMX) may be at increased risk of recurrence of TMP/SMX hypersensitivity following initiation of protease inhibitor therapy, and studies suggesting that, in HIV-infected patients, cytomegalovirus reactivation occurs a median of six months prior to the development of clinically detectable manifestations of cytomegalovirus infection are included. Questions on the length of prophylactic therapy and the role of prophylaxis in anergic patients who are being treated for Mycobacterium disease; risk factors associated with recurrent oral candidiasis in patients who received continuous antifungal therapy for less than three months; the detection of human herpesvirus eight DNA sequences in the semen of HIV-infected men without Kaposi's sarcoma; and occurrences of cervical dysplasia and genital tract infections in HIV-infected women are also discussed.
J Int Assoc Physicians AIDS Care 1997 Apr
PMID:Opportunistic infections: stemming the tide. 1136 2

A case study of an HIV-infected Caribbean male with extrapulmonary tuberculosis details his diagnosis, treatment regimens, and follow-up. His presenting symptoms included epigastric pain and fever. Endoscopy and gastric biopsy showed gastritis and helicobacter infection, which were treated symptomatically, and TMP-SMX was given for possible salmonellosis. Serologic tests for common opportunistic infections were negative. After all other expected conditions were ruled out, concurrent symptoms were diagnosed as extrapulmonary tuberculosis, and multi-drug treatment was successfully conducted. The problem of interactions between protease inhibitors and anti-tuberculosis drugs in treating HIV and tuberculosis concurrently is discussed. Three options are addressed: (1) discontinue (or delay starting) the protease inhibitor until at least 6 months of a standard rifampin-containing tuberculosis regimen is completed; (2) discontinue (or delay starting) the protease inhibitor until 2 months of a standard rifampin-containing regimen are completed; and (3) use of rifabutin rather than rifampin.
AIDS Clin Care 1997 Aug
PMID:Pursuing a diagnosis in a Caribbean man. 1136 79


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>